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TalkingNutrition

Providing perspectives on recent research into vitamins and nutritionals

Man-on-bathroom-scales

Avoiding Weight Discrimination and Early Death

By Michael McBurney

So many adages exist about nutrition and health. You are what you eat. An apple a day keeps the doctor away. Let your food be your medicine and your medicine be your food. Every time you eat is an opportunity to nourish your body. Less of this, more of that.

Not surprisingly, dietary choices and nutritional status affect body weight and chronic disease risk. Lifestyle behaviors (not smoking, healthy diet, and adequate physical behavior) often co-exist. Smoking and physical inactivity have greater consequences on the risk of dying than nutrition.

The odds ratio is a calculation estimating relative risk. Using this approach, low baseline serum vitamin E concentrations were associated with greater mortality in Finland, the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) and more recently cancer survival rates in ATBC participants. In population-based cohort studies, a 20 nmol/L increase in vitamin D levels is associated with an 8% lower mortality. Low vitamin D levels increase the risk of mortality among persons with obstructive lung function.

Risk calculations aren’t constrained to micronutrients. Odds ratios can be calculated for food and energy sources too. Consuming more free sugar is associated with increasing body fatness but the differences attributable to free sugar intake, e.g. body weight change, disappear when energy intake is kept constant.

Some behaviors are extremely risky. Smoking for 40 years (adjusted for number of cigarettes smoked) increases the risk of cancer 28-fold in women and 9-fold in men. Wearing seatbelts reduces the risk of dying in a car accident. People who are not wearing a seat belt are 30 times more likely to be ejected from a vehicle during a crash; 75% of those ejected will die from their injuries.

Risks can be additive. Normal-weight individuals are 67% more likely to wear seatbelts than the morbidly obese. Maintaining a healthy weight requires balancing food energy intake with energy expenditure. Failure to do so means weight gain.

A new study also reports that weight discrimination increases stepwise with increasing morbid obesity by 8 to 56-fold relative normal-weight individuals. Another reason to watch our diet.

Main Citation

Jackson SE, Steptoe A, Beeken RJ, Croker H, Wardle J. Perceived weight discrimination in England: a population-based study of adults aged ≥50 years. 2015 Int J Obes doi: 10.1038/ijo.2014.0186

Other Citations

Ford ES,  Bergmann MM, Boeing H, Li C, Capewell S. Healthy lifestyle behaviors and all-cause mortality among adults in the United States. 2012 Prev Med doi: 10.1016/j.ypmed.2012.04.016

Viera AJ. Odds ratios and risk ratios: what’s the difference and why does it matter? 2008 South Med J doi: 10.1097/SMJ.0b013e31817a7ee4

Schotter B, Ball D, Gellert C, Brenner H. Serum 25-hydroxyvitamin D levels and overall mortality. A systematic review and meta-analysis of prospective cohort studies. 2013 Ageing Res Rev doi: 10.1016/j.arr.2012.02.004

Ford ES. Lung function, 25-hydroxyvitamin D concentrations and mortality in US adults. 2015 EJCN doi: 10.1038/ejcn.2014.162

Risch HA, Howe GR, Jain M, Burch JD, Holowaty EJ, Miller AB. Are female smokers at higher risk of lung cancer than male smokers? A case-control analysis by histologic type. 1993 Am J Epidem 138 (5):281-293

Wright ME, Lawson KA, Weinstein SJ, Pietinen P, Taylor PR, Virtamo J, Albanes D. Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer prevention study. 2006 Am J Clin Nutr 84(5):1200-1207

Luoma PV, Nayha S, Sikkila K, Hassi J. High serum alpha-tocopherol, albumin, selenium and cholesterol, and low mortality from coronary heart disease in northern Finland. 1995 J Intern Med doi: 10.1111/j.1365-2796.1995.tb01139.x

Moy KA, Weinstein S, Mannisto S, Albanes D. Abstract 2183: Serum alpha-tocopherol, beta carotene and cancer survival in the ATBC Study. 2014 Cancer Res doi: 10.1158/1538-7445.AM2014-2183

Morenga LT, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomized controlled trials and cohort studies. 2013 BMJ doi: 10.1136/mbj.37492

Jehle D, Doshi C, Karagianis J, Consiglio J, Jehle G. Obesity and seatbelt use: a fatal relationship. Am J Emerg Med doi: 10.1016/j.ajem.2014.01.010


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